Objective To investigate the clinical value of endoscopic ultrasonography (EUS)on minute gas-tric stromal tumor (MGST).Methods 90 patients diagnosed with MGST were randomly divided into two groups. 45 patients in A group were given conventional endoscopic diagnosis,45 cases in B group were treated with endoscopic ultrasound diagnosis.After the two groups of patients with endoscopic treatment,the coincidence rate of preoperative diagnosis and pathological inspection test results was recorded,clinical features in MGST under EUS diagnosis were analyzed.Results All patients were diagnosed in the case of endoscopic surgery,endoscopic submucosal dissection (ESD)accounted for 94.44%,which was significantly higher than the use of endoscopic full -thickness resection (EFR)percentage of 5.56%,and the difference was statistically significant (χ2 =14.22,P <0.05);The two groups of patients after endoscopic treatment,were diagnosed as pathological inspection MGST.Preoperative diagnosis showed that EUS MGST suspected cases of 40 patients,conventional endoscopy MGST suspected cases of 31 cases.The diag-nosis coincidence rate of B group (88.89%)was significantly higher than that in A group (68.88%),the difference was statistically significant (χ2 =5.40,P <0.05);MGST of EUS images could be clearly observed in patients with tumor morphology,size,location,growth pattern,internal parenchyma,echo pattern,strengthening methods,the compo-sition ratio in line with the results of endoscopic treatment,diagnosis results in line with the pathological diagnosis. Conclusion EUS has significant value for the diagnosis of MGST,it has advantages in the clinical guidance and treatment.

OBJECTIVE:To improve the synthesis technology of sorafenib tosylate (Ⅰ). METHODS:The intermediate N-methyl-(4-chlorpyridin-2-yl)carboxamide(Ⅳ)was obtained by chlorination and amidation with 2-picolinic acid as the starting com-pound. Meanwhile,N-[4-chloro-3-(triflouromethyl)phenyl]-N′-(4-hydroxyphenyl)urea (Ⅶ) was prepared from aminophenol and 4-chloro-3-trifluoromethyl phenyl isocyanate,which was obtained from 4-chloro-3-(trifluoromethyl)aniline(Ⅴ)by reaction with initiator triethylamine. Sorafenib tosylate was synthesized from Ⅳ and Ⅶ with potassium tert-butoxide by condensation and salt for-mation. The target compound was characterized by 1H-NMR. RESULTS:The target compound was confirmed as Ⅰ,with the over-all yield of 74% [based on 4-chloro-3-(trifluoromethylanilin)]. The purification of chromatogram was 94%. Optimized technology improves yield and simplifies multi-step intermediate decompression,distillation and purification process;the application of initia-tor shortens the duration of reaction. CONCLUSIONS:Ⅰ is prepared successfully,and raw material can be obtained easily and is easy to operate with high yield.

Occupational Diseases ; prevention & control ; Occupational Health Services ; Public Health

BACKGROUND:There are many preliminary studies on the survival, metaptosis, and correlation characteristics of human amniotic epithelial cel s after transplanted into the animals, but there are no reports on the quantitative analysis of the transplantation effect. OBJECTIVE:To make quantitative analysis on serum biochemical function of liver and the expression of human albumin in mice received passaged human amniotic epithelial cel s transplantation in spleen. METHODS:Forty nude mice were randomly divided into four groups (n=10 in each group):hepatectomy+cel transplantation 2 weeks group, hepatectomy+cel transplantation 4 weeks group, hepatectomy+normal saline group (treated with partial hepatectomy) and hepatectomy+cel transplantation group (transplanted with 0.2 mL passaged human amniotic epithelial cel s with 5×106 under spleen, and the blood were col ected at 2 and 4 weeks after transplantation). The mice in the hepatectomy+normal saline group were treated with splenic injection of 0.2 mL normal saline;the cel transplantation group did not receive hepatectomy, and transplanted with 0.2 mL passaged human amniotic epithelial cel s with 5×106 under spleen. The histological and morphological changes of the liver and spleen in each group as wel as the expressions of serum alanine aminotransferase, aspartate aminotransferase and human serum albumin in each group were detected, and the quantitative analysis of human serum albumin expression was performed. RESULTS AND CONCLUSION: There was no obvious morphological change after human amniotic epithelial cel s transplanted into the acute liver injury mice for 4 weeks, but specific cel s could be detected by histological method. The serum levels of alanine aminotransferase, aspartate aminotransferase and human serum albumin were improved obviously, and the human albumin could be detected in serum, the level of human albumin at 4 weeks after transplantation was significantly increased than 2 weeks after transplantation. Human amniotic epithelial cel s can survive for more than 4 weeks after transplanted into the liver injury mice, and can stil express partial characteristics and functions of hepatocyte-like cel s, improve the liver function, thus treating acute liver injury.

Objective To explore whether the presence of juxtapapillary duodenal diverticula (JPDD) risks biliary stone disease and recurrence.Methods 829 patients undergoing ERCP in our hospital from Aug 2008 to Dec 2012 were divided into four groups:biliary stone disease (n =609) non-stone biliary abnormality (n =124) common bile duct malformation with cholelithiasis (n =38) and normal control group (n =58).There were 206 patients with JPDD and 623 patients without JPDD.Biliary stoneformation,post-ERCP pancreatitis,cannulation failure,and stone recurrence were compared between those with JPDD and those without.Results The incidence of JPDD in biliary stone disease group (27.8％) was significantly higher than in non-stone biliary anatomical abnormality group (18.5 ％) (x2 =4.512,P ＜ 0.05).In biliary stone disease group,rates of post-ERCP pancreatitis were significantly higher in JPDD cases (33.7％) compared to those without JPDD (13.8％) (x2 =30.841,P ＜ 0.05).The cannulation failure rate was also higher in patients with JPDD (15.4％) compared to JPDD negative (6.8％) (x2 =0.731,P ＜0.05).Recurrence rates in biliary stone disease were significantly higher in patients with JPDD (19.5％) when compared to JPDD-lacking individuals (9.3％) (x2 =14.51,P ＜ 0.05).Conclusions JPDD is a risk factor for biliary stone formation.JPDD also is associated with post-ERCP pancreatitis,cannulation failure and biliary stone recurrence.

To assess the effectiveness and safety ofinside-out (TVT-O) vs. outside-in transobturator-tape procedures (TOT) in the surgical management of female stress urinary incontinence (SUI).A total of 8 randomized controlled trials were retrieved from the literature and analyzed by metaanalysis with RevMan 5.0 software.Meta-analysis showed that no statistical differences existed in objective cure rate,objective failure,postoperative voiding dysfunction,groin/thigh pain and sling exposure in both procedures (P ＞ 0.05).These preliminary results suggest there is no evidence of significant differences in the efficacy and safety between TVT-O and TOT.

The traditional view of bacterial life cycle consists of four phases,namely,lag phase,exponential or logarithmic phase,stationary phase and death phase.Although the standard textbook description of the bacterial life cycle has been useful,might not always provide us the whole visage of bacteria growth process.Recently,it has demonstrated that bacterial life cycle is expanded to five phases.It is a significant different growth phase after death phase:long-term stationary phase,which may be more akin to the nature environment in which microorganisms exist.Microbial cells survive due to mutating,and forming growth advantage during stationary phase (GASP) phenotype in this phase.It is very important for further study the microorganisms in this phase.

Objective To summarize the progress on the injury mechanism of vascular endothelial cells in atherosclerosis.Methods The latest progress was reviewed in recent literatures.Results All kinds of etiological factors have activated NF kappa B and cytokines in the development of atherosclerosis, which lead to expression of cell adhesive molecules and adhesion of monocytes to vascular endothelial cells.A variety of inflammatory mediums are released, which can directly damage endothelial cells.Besides, the inflammatory mediums make monocytes and neutrophils attach to endothelial cells by immune mechanisms, which injure the endothelial cells more severely. Meanwhile the damaged membrance structure leads to the production of AECA which activates the complementary system. Then the vascular endothelial cell injury is aggravated and the development of atherosclerosis accelerated. Conclusion It is very important to recognize the injury mechanism of vascular endothelial cells in the development of atherosclerosis for prevention and treatment of atherosclerosis.

Objectives To investigate the relationship between angiogenesis and vascular endothelial growth factor (VEGF) and its receptor in patients with psoriasis. Methods The expression of VEGF and its receptor KDR, and micro-vascular density (MVD) were measured in 42 patients with psoriasis vulgaris and 15 normal controls by in situ hybridization and immunohistochemistry technique, respectively. The concentration of VEGF in sera was measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA) in patients with psoriasis vulgaris and normal controls. Results ①The expression of VEGF mRNA and its protein, KDR, and MVD in psoriatic lesions were significantly higher than those in the normal controls (P

Objective To investigate the mechanism of effects of acitretin on the treatment of psoriasis. Methods The expression of vascular endothelial growth factor (VEGF) and micro-vascular density (MVD) were detected by immunohistochemical technique before and after treatment with acitretin in 32 patients with psoriasis. Serum level of VEGF was measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Results The expression of VEGF protein and MVD were significantly higher in psoriatic lesions before treatment with acitretin than those after treatment (P